Women who give birth as adolescents are at increased risk for low birth weight (LBW) and preterm birth (PTB). These complications have far-reaching medical and financial implications for both mother and child. However, the majority of teenage mothers give birth to healthy babies. Younger age and underweight are associated with higher risk of poor birth outcome; otherwise, few risk or protective factors are known. We conceptualize three levels that may affect a girl's pregnancy health. The girl's own resources will contribute to her ability to have positive health behaviors, access adequate medical care, and control her stress levels. Second, the micro system in which she operates - particularly her family - provides the instrumental, informational, and emotional support to encourage or discourage good health. Third, the context of the neighborhood and school she attends will provide the backdrop for a girl's attitudes and behavior. The National Longitudinal Study of Adolescent Health's (Add Health) collected data on adolescents across 4 Waves, including information on pregnancies and births. Participants reported on several aspects of their lives and families, and data were also gathered from parents, friends, and school administrators, allowing for a broad picture of the context in which participants were developing. As of Wave III, 913 women experienced at least one adolescent pregnancy (before age 20). Our specific aims are: 1) To examine how individual resources (self-esteem, intelligence, mental health, self- efficacy) affect birth weight and gestational age in adolescent girls; 2) To examine how micro system strengths and weaknesses (family closeness, family disadvantage, mistreatment, parental relationship quality, parental support), and neighborhood/school resources (school disadvantage, availability of health care, frequency of teen pregnancy, quality of education) affect birth outcomes in teenage girls, and to examine interactions among the higher levels and individual levels, and 3) To examine the relationship between these resources and potential intermediates such as prenatal care and health behaviors. The public health goals served by this project include identifying high- and low-risk subsets within this high-risk group, and identifying opportunities for interventions which could decrease the negative consequences of these births to young mothers. PUBLIC HEALTH RELEVANCE: Overall, women who give birth as adolescents are at increased risk for low birth weight (LBW) and preterm birth (PTB); however, few risk or protective factors are known within this group. Data from the National Longitudinal Study of Adolescent Health (Add Health) will be used to examine individual, family, and neighborhood/school influences on pregnancy outcome among adolescents and intermediates such as prenatal care and smoking during pregnancy. The public health goals served by this project are identifying high- and low-risk subsets within this high-risk group, and identifying opportunities for interventions which could decrease the negative consequences of these births to young mothers.